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  • 101. Ali Mohamed, Fowzia
    et al.
    Kvalfors, Wenche
    Sjuksköterskors upplevelse av att möta aggressivitet från patienter inom psykiatrisk vård  -En litteraturöversikt2023Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
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  • 102.
    Alimoradi, Z.
    et al.
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Griffiths, M. D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Application of online cognitive-behavioral therapy for insomnia among individuals with epilepsy2023In: Handbook of Cognitive Behavioral Therapy by Disorder: Case Studies and Application for Adults / [ed] C. R. Martin,V. B. Patel & V. R. Preedy, Elsevier , 2023, p. 409-415Chapter in book (Other academic)
    Abstract [en]

    Approximately 50 million individuals worldwide suffer from epilepsy, which has various neurological, cognitive, psychological, and social consequences including insomnia. Several factors may explain insomnia among individuals with epilepsy including new diagnoses of epilepsy, changes at work, school, and social role changes. Moreover, anxiety, stress, and insecurity about seizure control can contribute to insomnia. Nonpharmacological methods including cognitive-behavioral therapy can be used to alleviate insomnia. Cognitive-behavioral therapy is a type of psychotherapy that focuses on the effect of an individual’s beliefs, thoughts, and attitudes on their feelings and behaviors. Cognitive-behavioral therapy for insomnia (CBT-I) is one of the therapies in sleep science and uses the general principles of cognitive-behavioral therapy and is designed to eliminate the symptoms of insomnia. The internet is an emerging platform for mental health services worldwide. Internet-based CBT or CBT-I has been used for insomnia with promising results. If the content of CBT-I-based technology (which is disseminated via the internet, e-mail, or mobile phone) is of good quality and has credible evidence-based experiences, it will have positive therapeutic effects and initial patient acceptance. This chapter introduces the application of a six-session online CBT-I for three individuals with epilepsy. The content can also be used as a guide for treating insomnia among individuals with epilepsy.

  • 103.
    Alimoradi, Z.
    et al.
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Griffiths, M. D.
    International Gaming Research Unit, Psychology Department, Nottingham Trent University, Nottingham, United Kingdom.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Nursing Science. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Epilepsy, sexual function, and mindfulness-based cognitive therapy2023In: Handbook of Cognitive Behavioral Therapy by Disorder: Case Studies and Application for Adults / [ed] C. R. Martin,V. B. Patel & V. R. Preedy, Elsevier , 2023, p. 135-146Chapter in book (Other academic)
    Abstract [en]

    Epilepsy, like many common medical disorders, can cause sexual dysfunction. However, the prevalence and nature of sexual dysfunction among people with epilepsy, its causes, and optimal management strategies are unclear. Sexual dysfunction in epilepsy is caused by several factors including disease-related factors and drug treatment, psychiatric factors, and social factors. Due to the significant prevalence of sexual dysfunction among patients with epilepsy, the synergistic effect of sexual dysfunction, and mental disorders, design and implementation of psychological interventions including mindfulness-based cognitive therapy (MBCT) for sexual disorders among patients with epilepsy have been proposed. MBCT is an approach to psychotherapy that uses cognitive-behavioral therapy (CBT) techniques alongside mindfulness meditation techniques. MBCT protocol has been adapted to treat female sexual dysfunction of different groups including epilepsy showing promising effects. Consequently, issues concerning sexual activity should be raised by healthcare professionals as a routine part of the management of patients with epilepsy, and MBCT can be considered as a promising effective treatment strategy.

  • 104.
    Alimoradi, Zainab
    et al.
    Qazvin Univ Med Sci, Iran.
    Broström, Anders
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology. Jonkoping Univ, Sweden.
    Potenza, Marc N.
    Yale, CT USA; Sch Med, CT USA; Connecticut Council Problem Gambling, CT USA; Connecticut Mental Hlth Ctr, CT USA.
    Lin, Chung-Ying
    Natl Cheng Kung Univ, Taiwan.
    Pakpour, Amir H.
    Qazvin Univ Med Sci, Iran; Jonkoping Univ, Sweden.
    Associations Between Behavioral Addictions and Mental Health Concerns During the COVID-19 Pandemic: A Systematic Review and Meta-analysis2024In: Current Addiction Reports, E-ISSN 2196-2952Article, review/survey (Refereed)
    Abstract [en]

    Purpose of ReviewThe COVID-19 pandemic has promoted behavioral changes and elevated mental distress. Addictive behaviors often increased, generating mental health problems. The present study's primary aim was to investigate associations between different types of behavioral addictions (including behavioral addictions, related conditions, and phenomena) and different types of mental health problems. The secondary aims were: (i) to identify possible sources of heterogeneity and (ii) to explore potential moderators in associations between different types of behavioral addictions (including behavioral addictions, related conditions, and phenomena) and different types of mental health problems.Recent FindingsUsing Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), studies from the period between December 2019 and May 2023 were sought from PubMed, Scopus, ISI Web of Knowledge, and Google Scholar in its first ten pages. The articles' relevance was screened and evaluated. The included papers' quality was assessed according to the Newcastle Ottawa Scale. Fisher's Z scores were computed to present magnitudes of associations and I2 indices were used to estimate levels of heterogeneity in the meta-analysis. Among the 85 included studies (N = 104,425 from 23 countries; mean age = 24.22 years; 60.77% female), most were internet-related behavioral addictions, related conditions, and phenomena (28 studies on social media, 25 on internet, 23 on smartphone, and 12 on gaming). The pooled estimation of the associations showed that higher levels of behavioral addictions, related conditions, and phenomena related to internet use (regardless of type) were associated with more mental health problems (regardless of which type). Moderator analyses showed that almost no variables affected heterogeneity for the founded associations.SummaryMost studies of behavioral addictions, related conditions, and phenomena focused on internet-related behaviors, with studies suggesting relationships with specific types of mental health problems during the COVID-19 pandemic. Moreover, associations between behavioral addictions (including behavioral addictions, related conditions, and phenomena) and mental health problems found in the present systematic review and meta-analysis were comparable to the associations identified in studies conducted before the COVID-19 pandemic. How to help people reduce internet-related behavioral addictions, related conditions, and phenomena and address associated mental health concerns are important topics for healthcare providers.

  • 105.
    Alimoradi, Zainab
    et al.
    Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Gozal, David
    Department of Child Health and the Child Health Research Institute, The University of Missouri School of Medicine, Columbia, MO, USA.
    Tsang, Hector W. H.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.
    Lin, Chung-Ying
    Institute of Allied Health Sciences, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Ohayon, Maurice M.
    Stanford Sleep Epidemiology Research Center (SSERC), School of Medicine, Stanford University, Palo Alto, CA, USA.
    Pakpour, Amir H.
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Nursing Science. Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
    Gender-specific estimates of sleep problems during the COVID-19 pandemic: Systematic review and meta-analysis2022In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 31, no 1, article id e13432Article, review/survey (Refereed)
    Abstract [en]

    The outbreak of the novel coronavirus disease 2019 (COVID-19) changed lifestyles worldwide and subsequently induced individuals? sleep problems. Sleep problems have been demonstrated by scattered evidence among the current literature on COVID-19; however, little is known regarding the synthesised prevalence of sleep problems (i.e. insomnia symptoms and poor sleep quality) for males and females separately. The present systematic review and meta-analysis aimed to answer the important question regarding prevalence of sleep problems during the COVID-19 outbreak period between genders. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline and Newcastle?Ottawa Scale checklist, relevant studies with satisfactory methodological quality searched for in five academic databases (Scopus, PubMed Central, ProQuest, Web of Science , and EMBASE) were included and analysed. The protocol of the project was registered in the International Prospective Register of Systematic Reviews (PROSPERO; identification code CRD42020181644). A total of 54 papers (N = 67,722) in the female subgroup and 45 papers (N = 45,718) in the male subgroup were pooled in the meta-analysis. The corrected pooled estimated prevalence of sleep problems was 24% (95% confidence interval [CI] 19%?29%) for female participants and 27% (95% CI 24%?30%) for male participants. Although in both gender subgroups, patients with COVID-19, health professionals and general population showed the highest prevalence of sleep problems, it did not reach statistical significance. Based on multivariable meta-regression, both gender groups had higher prevalence of sleep problems during the lockdown period. Therefore, healthcare providers should pay attention to the sleep problems and take appropriate preventive action.

  • 106.
    Alimoradi, Zainab
    et al.
    Qazvin Univ Med Sci, Iran.
    Majd, Nilofar Rajabi
    Qazvin Univ Med Sci, Iran.
    Broström, Anders
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Clinical Neurophysiology. Jonkoping Univ, Sweden.
    Tsang, Hector W. H.
    Hong Kong Polytech Univ, Peoples R China.
    Singh, Parmveer
    Khalsa Coll Amritsar, India.
    Ohayon, Maurice M.
    Stanford Univ, CA 94305 USA.
    Lin, Chung-Ying
    Natl Cheng Kung Univ, Taiwan; Natl Cheng Kung Univ, Taiwan; Natl Cheng Kung Univ, Taiwan; Natl Cheng Kung Univ, Taiwan.
    Pakpour, Amir H.
    Qazvin Univ Med Sci, Iran; Jonkoping Univ, Sweden.
    Is alexithymia associated with sleep problems? A systematic review and meta-analysis2022In: Neuroscience and Biobehavioral Reviews, ISSN 0149-7634, E-ISSN 1873-7528, Vol. 133, article id 104513Article, review/survey (Refereed)
    Abstract [en]

    Alexithymia, a difficulty identifying and expressing emotions experienced by oneself or others, measurably harms quality of sleep. Research has observed the association between alexithymia and sleep problems; however, the cumulative effect of this association is still unknown. Therefore, this systematic review and meta-analysis was conducted to present scientific evidence regarding the relationship between alexithymia and sleep quality. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline, and using relevant keywords, we searched six databases: Scopus, PubMed Central, ProQuest, ISI Web of Knowledge, EMBASE, and Science Direct. We selected observational studies on the association between alexithymia and sleep. We conducted meta-analysis using a random-effect model to calculate the effect size (ES) with Fishers z transformation. Eligible studies (N = 26) in 24 papers included 7546 participants from 12 countries. The entire ES for the association between alexithymia and sleep was 0.44 (95 % CI: 0.31, 0.56). Additionally, patient populations had a larger ES (ES = 0.55; 95 % CI: 0.30, 0.79) than healthy populations (ES = 0.30; 95 % CI: 0.20, 0.41). The results of the present systematic review and meta-analysis revealed a significant association between alexithymia and sleep problems, especially among people with any medical condition.

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  • 107.
    Allard, Per
    et al.
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Gustafson, Lars
    Karlsson, Ingvar
    Björkstén, Karin Sparring
    Geriatric psychiatry in Sweden must be developed--not dismantled: New investigation shows depressing results2009In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 106, no 1-2, p. 36-9Article in journal (Refereed)
  • 108.
    Allerby, Katarina
    et al.
    Sahlgrens Univ Hosp, Gothenburg, Sweden..
    Goulding, Anneli
    Univ Gothenburg, Sahlgrenska Univ Hosp, Gothenburg, Sweden..
    Ali, Lilas
    Univ Gothenburg, Sahlgrenska Univ Hosp, Gothenburg, Sweden..
    Gremyr, Andreas
    Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Sahlgrenska Univ Hosp, Gothenburg, Sweden.
    Waern, Margda
    Univ Gothenburg, Sahlgrenska Univ Hosp, Gothenburg, Sweden..
    Person-Centered Psychosis Care How Increasing Person-Centeredness In Psychosis Inpatient Care Relate To Care Consumption And Ward Burden2020In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 46, no Supplement 1, p. S323-S323Article in journal (Refereed)
  • 109.
    Allerby, Katarina
    et al.
    Sahlgrenska Univ Hosp, Gothenburg, Sweden.
    Goulding, Anneli
    Univ Gothenburg, Sahlgrenska Univ Hosp, Gothenburg, Sweden.
    Ali, Lilas
    Univ Gothenburg, Sahlgrenska Univ Hosp, Gothenburg, Sweden.
    Gremyr, Andreas
    Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Sahlgrenska Univ Hosp, Gothenburg, Sweden.
    Waern, Margda
    Univ Gothenburg, Sahlgrenska Univ Hosp, Gothenburg, Sweden.
    Person-Centered Psychosis Care (PCPC) In An Inpatient Setting: Ward Level Data And Staff Workload2019In: Schizophrenia Bulletin, ISSN 0586-7614, E-ISSN 1745-1701, Vol. 45, no Supplement 2, p. S304-S304Article in journal (Refereed)
    Abstract [en]

    Background: The person-centered care approach has been little tested in inpatient settings for persons with schizophrenia. An intervention, PersonCentered Psychosis Care (PCPC), was created to increase person-centered care through an educational intervention for staff. The education had a participatory approach where participants were involved in shaping the education and creating projects aimed at care development. The PCPC intervention focused on the patient’s narrative, the creation of a partnership between the patient and staff, and on coming to an agreement between the patient and staff concerning the care. The present study aims to compare staff experienced workload and ward level data before and after implementation of the intervention.

    Methods: The study was carried out on 4 hospital wards (43 beds) at the Psychosis Clinic, Gothenburg, Sweden. Data was collected during a 6-month pre-intervention period, followed by an implementation period of 3  years, and finally a post intervention data collection period (9 months). During both data collection periods, one nurse per ward filled out a measure of daily subjective workload (a VAS scale with 0 indicating no burden at all and 10 indicating the highest imaginable burden). Additional ward level data (length of hospital stay, involuntary interventions, rehospitalization rates) were collected via the clinic’s electronic monitoring system.

    Results: The pre-intervention ratings (n=505) showed a mean subjective workload of 5.48 (SD=1.94). The post intervention workload (n=465) showed a mean of 4.51 (SD=2.08) which represents a significant reduction of experienced workload (t (968) = p <.0005). Analyses regarding length of hospital stay, involuntary interventions, and rehospitalization rates are underway and will be presented.

    Discussion: The findings indicate an improvement in the work environment for hospital staff and provide a quantitative result in line with staff experiences previously reported in our focus group study. The before and after design has its limitations, but the positive findings motivate further testing with a more rigorous design such as a cluster randomized study.

  • 110.
    Allodi Westling, Mara
    Stockholm University, Faculty of Social Sciences, Department of Special Education.
    The experiences of mental health and well-being of Swedish children and youth with a focus on educational situations: Some results and reflections from a review of qualitative studies2010In: Trender i barns och ungdomars psykiska hälsa: Program & abstracts 12-14 april 2010, Stockholm: Kungliga vetenskapsakademien , 2010, p. 17-18Conference paper (Other academic)
    Abstract [en]

    The practice of including in reviews people’s experiences and perceptions, which are collected with non-experimental and qualitative studies, has been developed recently in the field of mental health studies. These approaches and methodologies have inspired the review of research on Swedish children and adolescents experiences of mental health and well being, with a focus on their educational situation, that was conducted as a part of a systematic review of research on School Learning and Mental health, performed by appointment of the Royal Academy of Sciences. The aim of the review was to gather testimonies that can give indications of the experiences of mental health and well being in this specific context. The results from the studies that were relevant for the aims of the review are structured in four themes: general views, protective factors, risk factors, individual factors. They are presented in a narrative synthesis, giving a particular weight to the direct and indirect report of children’s and adolescents’ own views. The adolescents defined mental health as emotional experiences, seen both as internal feelings and as relational feelings. Family, friends and educational environments as social and physical environments were perceived as determinants of mental health. A great number of feelings were related to school, both related to satisfaction and pain, in particular when the school attendance is presented as an obligation. Harassment and rejection at school, performance stress, worries about grades and future prospects could be threats against self-worth and self-esteem, while teachers that do not care could generate negative experiences. Various kind of stress could be described and various strategies to resist stressful situations: for instance emotional support, safety and involvement. The educational environments can be an arena for social, cognitive and emotional experiences, relationships and accomplishments that are enriching the individuals and increase their well being. General structural characteristics of the educational environments may also affect well being in different directions: performance, evaluation and feedback, freedom of choice and responsibility for the future may be perceived as a burden. The following reflections can be made: the experiences of children and adolescents change when they grow older, go through developmental processes and encounter different educational situations; the studies reporting views of younger children on the matters of this review were less well represented; the negative experiences may be expressed in rather cautious and non dramatic terms by younger children; there are unique contribution of the review of qualitative studies, but also several interesting correspondences with the results of the review of quantitative studies.

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  • 111. Alm, C.
    et al.
    Eriksson, A.
    Durbeej, N.
    Palmstierna, T.
    Berman, Anne H.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Kristiansson, M.
    Gumpert, C. H.
    Classification of offenders with mental health problems and problematic substance use using the Addiction Severity Index version 6: Analysis of three-year follow-up data and predictive validity2014In: Mental Health and Substance Use: Dual Diagnosis, Vol. 7, no 4, p. 431-445Article in journal (Refereed)
    Abstract [en]

    Previous research is scarce on the problems and needs of the “triply troubled” – among offenders with mental health problems and problematic substance use. Classifying this population into clusters based on problem profiles may provide information about individual needs for treatment. In a previous study, we identified four clusters of triply troubled: less troubled, severely triply troubled, triply troubled with medical problems, and working triply troubled. The present study explored the stability and predictive validity of these clusters in a naturalistic design. In total, 125 triply troubled individuals included in any of the four clusters were followed for approximately three years with regard to their inpatient and outpatient treatment participation. They were also interviewed with the 6th version of the Addiction Severity Index, the Psychopathy Checklist–Revised, and the World Health Organization Quality of Life–Bref. The main finding of the study was that on average the participants of all four clusters exhibited substantial improvements over the course of time but that improvements were cluster-specific rather than sample-specific. Implications of the study are discussed.

  • 112. Alm, Charlotte
    et al.
    Berman, Anne H.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Kristiansson, Marianne
    Lindqvist, Per
    Palmstierna, Tom
    Gumpert, Clara Hellner
    Gender differences in re-offending among psychiatrically examined Swedish offenders2010In: CBMH. Criminal behaviour and mental health, ISSN 0957-9664, E-ISSN 1471-2857, Vol. 20, no 5, p. 323-334Article in journal (Refereed)
  • 113. Alm, Charlotte
    et al.
    Eriksson, Asa
    Palmstierna, Tom
    Kristiansson, Marianne
    Berman, Anne H.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Gumpert, Clara Hellner
    Treatment Patterns Among Offenders with Mental Health Problems and Substance Use Problems2011In: Journal of Behavioral Health Services & Research, ISSN 1094-3412, E-ISSN 1556-3308, Vol. 38, no 4, p. 497-509Article in journal (Refereed)
  • 114.
    Alm, Susanne
    et al.
    Swedish Institute of Social Research, Stockholm University, Sweden.
    Brolin Låftman, Sara
    Department of Public Health Sciences, Centre for Health Equity Studies (CHESS), Stockholm University, Sweden.
    Sivertsson, Fredrik
    Department of Criminology, Stockholm University, Sweden.
    Bohman, Hannes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Child and Adolescent Psychiatry. Department of Women’s and Children’s Health, Akademiska University Hospital, Sweden Stockholm Health Care Services, Stockholm County Council, Sweden.
    Poor family relationships in adolescence as a risk factor of in-patient psychiatric care across the life course: A prospective cohort study2020In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 48, no 7, p. 726-732, article id 10.1177/1403494820902914Article in journal (Refereed)
    Abstract [en]

    Background: Previous research has shown that poor family relations in childhood are associated with adverse mental health in adulthood. Yet, few studies have followed the offspring until late adulthood, and very few have had access to register-based data on hospitalisation due to psychiatric illness. The aim of this study was to examine the association between poor family relations in adolescence and the likelihood of in-patient psychiatric care across the life course up until age 55. Methods: Data were derived from the Stockholm Birth Cohort study, with information on 2638 individuals born in 1953. Information on family relations was based on interviews with the participants' mothers in 1968. Information on in-patient psychiatric treatment was derived from administrative registers from 1969 to 2008. Binary logistic regression was used. Results: Poor family relations in adolescence were associated with an increased risk of later in-patient treatment for a psychiatric diagnosis, even when adjusting for other adverse conditions in childhood. Further analyses showed that poor family relations in adolescence were a statistically significant predictor of in-patient psychiatric care up until age 36-45, but that the strength of the association attenuated over time. Conclusions: Poor family relationships during upbringing can have serious negative mental-health consequences that persist into mid-adulthood. However, the effect of poor family relations seems to abate with age. The findings point to the importance of effective interventions in families experiencing poor relationships.

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  • 115.
    Alm, Susanne
    et al.
    Stockholm Univ, Dept Criminol, SE-10691 Stockholm, Sweden..
    Låftman, Sara Brolin
    Stockholm Univ, Ctr Hlth Equ Studies CHESS, Dept Publ Hlth Sci, SE-10691 Stockholm, Sweden..
    Bohman, Hannes
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Ramklint: Child and Adolescent Psychiatry. Akad Univ Hosp, Dept Womens & Childrens Hlth, SE-75185 Uppsala, Sweden.;Stockholm Cty Council, Stockholm Hlth Care Serv, Stockholm, Sweden..
    Poor family relationships in adolescence as a risk factor of in-patient somatic care across the life course: Findings from a 1953 cohort2021In: SSM - Population Health, ISSN 2352-8273, Vol. 14, article id 100807Article in journal (Refereed)
    Abstract [en]

    Background: Prior research has shown that poor family relations during upbringing have long-term detrimental effects on mental health. Few previous studies have, however, focused on somatic health outcomes and studies rarely cover the life span until retirement age. The aims of the current study were, firstly, to examine the association between poor family relationships in adolescence and in-patient somatic care across the life course whilst adjusting for confounders at baseline and concurrent psychiatric in-patient care; and secondly, to compare the risks of somatic and psychiatric in-patient care across the life course.

    Methods: Prospective data from the Stockholm Birth Cohort study were used, with 2636 participants born in 1953 who were followed up until 2016. Information on family relationships was collected from the participants' mothers in 1968. Annual information on in-patient somatic and psychiatric care was retrieved from official register data from 1969 to 2016.

    Results: Poisson regressions showed that poor family relationships in adolescence were associated with an increased risk of in-patient somatic care in mid- and especially in late adulthood (ages 44-53 and 54-63 years), even when controlling for the co-occurrence of psychiatric illness and a range of childhood conditions. No statistically significant association was observed in early adulthood (ages 16-43 years), when controlling for confounders. These findings are in sharp contrast to the analyses of inpatient psychiatric care, according to which the association with poor family relations was strongest in early adulthood and thereafter attenuated across the life course.

    Conclusion: Poor family relationships in adolescence are associated with an increased risk of severe consequences for somatic health lasting to late adulthood even when controlling for confounders including in-patient psychiatric care, emphasising the potentially important role of early interventions.

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  • 116.
    Alme, Tomas Nordheim
    et al.
    Akershus Univ Hosp, Norway.
    Andreasson, Anna
    Karolinska Inst, Sweden.
    Asprusten, Tarjei Torre
    Vear Gen Practitioner Grp, Norway.
    Bakken, Anne Karen
    VID Specialized Univ, Norway; St Olavs Hosp, Norway.
    Beadsworth, Michael B. J.
    Liverpool Univ Hosp Fdn Trust, England.
    Boye, Birgitte
    Univ Oslo, Norway; Oslo Univ Hosp, Norway.
    Brodal, Per Alf
    Univ Oslo, Norway.
    Brodwall, Elias Myrstad
    Akershus Univ Hosp, Norway; Univ Oslo, Norway.
    Brurberg, Kjetil Gundro
    Norwegian Inst Publ Hlth, Norway.
    Bugge, Ingrid
    Oslo Univ Hosp, Norway.
    Chalder, Trudie
    Inst Psychiat, England.
    Due, Reidar
    Akershus Univ Hosp, Norway.
    Eriksen, Hege Randi
    Western Norway Univ Appl Sci, Norway.
    Fink, Per Klausen
    Aarhus Univ Hosp, Denmark.
    Flottorp, Signe Agnes
    Norwegian Inst Publ Hlth, Norway; Univ Oslo, Norway.
    Fors, Egil Andreas
    Norwegian Univ Sci & Technol NTNU, Norway.
    Jensen, Bard Fossli
    Kreftregisteret, Norway.
    Fundingsrud, Hans Petter
    Univ Hosp North Norway, Norway.
    Garner, Paul
    Univ Liverpool Liverpool Sch Trop Med, England.
    Havdal, Lise Beier
    Akershus Univ Hosp, Norway.
    Helgeland, Helene
    Lovisenberg Diakonale Hosp, Norway.
    Jacobsen, Henrik Borsting
    Oslo Univ Hosp, Norway; Univ Oslo, Norway.
    Johnson, Georg Espolin
    Univ Oslo, Norway.
    Jonsjoe, Martin
    Karolinska Univ Hosp, Sweden; Karolinska Inst, Sweden.
    Knoop, Hans
    Amsterdam Univ Med Ctr, Netherlands.
    Landmark, Live
    NTNU, Norway; Univ Oslo, Norway.
    Launes, Gunvor
    Univ Bergen, Norway.
    Lekander, Mats
    Karolinska Inst, Sweden.
    Linnros, Hannah
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Lindsaeter, Elin
    Karolinska Inst, Sweden.
    Liira, Helena
    Helsinki Univ Hosp, Finland.
    Linnestad, Lina
    Genok, Norway.
    Loge, Jon Hvard
    Univ Oslo, Norway.
    Lyby, Peter Solvoll
    CatoSenteret Rehabil Ctr, Norway.
    Malik, Sadaf
    Akershus Univ Hosp, Norway.
    Malt, Ulrik Fredrik
    Univ Oslo, Norway.
    Moe, Trygve
    Norsk Sykepleierforbund, Norway.
    Norlin, Anna-Karin
    Linköping University, Department of Health, Medicine and Caring Sciences, Division of Prevention, Rehabilitation and Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center.
    Pedersen, Maria
    Akershus Univ Hosp, Norway; Univ Oslo, Norway.
    Pignatiello, Siv Elin
    Oslo Univ Hosp, Norway.
    Rask, Charlotte Ulrikka
    Aarhus Univ Hosp, Denmark.
    Reme, Silje Endresen
    Oslo Univ Hosp, Norway; Univ Oslo, Norway.
    Roksund, Gisle
    Vear Gen Practitioner Grp, Norway.
    Sainio, Markku
    HUS Helsinki Univ Hosp, Finland.
    Sharpe, Michael
    Univ Oxford, England.
    Thorkildsen, Ruth Foseide
    Diakonhjemmet Hosp, Norway.
    van Roy, Betty
    Akershus Univ Hosp, Norway.
    Vandvik, Per Olav
    Lovisenberg Diaconal Hosp, Norway.
    Vogt, Henrik
    Univ Oslo, Norway.
    Wyller, Hedda Bratholm
    Oslo Univ Hosp, Norway.
    Wyller, Vegard Bruun Bratholm
    Akershus Univ Hosp, Norway; Univ Oslo, Norway.
    Chronic fatigue syndromes: real illnesses that people can recover from2023In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 41, no 4, p. 372-376Article in journal (Refereed)
    Abstract [en]

    The Oslo Chronic Fatigue Consortium consists of researchers and clinicians who question the current narrative that chronic fatigue syndromes, including post-covid conditions, are incurable diseases. Instead, we propose an alternative view, based on research, which offers more hope to patients. Whilst we regard the symptoms of these conditions as real, we propose that they are more likely to reflect the brains response to a range of biological, psychological, and social factors, rather than a specific disease process. Possible causes include persistent activation of the neurobiological stress response, accompanied by associated changes in immunological, hormonal, cognitive and behavioural domains. We further propose that the symptoms are more likely to persist if they are perceived as threatening, and all activities that are perceived to worsen them are avoided. We also question the idea that the best way to cope with the illness is by prolonged rest, social isolation, and sensory deprivation.Instead, we propose that recovery is often possible if patients are helped to adopt a less threatening understanding of their symptoms and are supported in a gradual return to normal activities. Finally, we call for a much more open and constructive dialogue about these conditions. This dialogue should include a wider range of views, including those of patients who have recovered from them.

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  • 117.
    Almeida, Osvaldo P.
    et al.
    Univ Western Australia, Perkins Inst Med Res, Med Res Ctr, Western Australian Ctr Hlth & Ageing M573, Crawley, WA 6009, Australia;Univ Western Australia, Sch Psychiat & Clin Neurosci, Crawley, WA 6009, Australia;Royal Perth Hosp, Dept Psychiat, Perth, WA 6000, Australia.
    MacLeod, Colin
    Univ Western Australia, Sch Psychol, Crawley, WA 6009, Australia.
    Ford, Andrew
    Univ Western Australia, Perkins Inst Med Res, Med Res Ctr, Western Australian Ctr Hlth & Ageing M573, Crawley, WA 6009, Australia;Univ Western Australia, Sch Psychiat & Clin Neurosci, Crawley, WA 6009, Australia;Royal Perth Hosp, Dept Psychiat, Perth, WA 6000, Australia.
    Grafton, Ben
    Univ Western Australia, Sch Psychol, Crawley, WA 6009, Australia.
    Hirani, Varsha
    Univ Western Australia, Perkins Inst Med Res, Med Res Ctr, Western Australian Ctr Hlth & Ageing M573, Crawley, WA 6009, Australia;Univ Western Australia, Sch Psychiat & Clin Neurosci, Crawley, WA 6009, Australia.
    Glance, David
    Univ Western Australia, Ctr Software Practice, Crawley, WA 6009, Australia.
    Holmes, Emily A.
    MRC, Cognit & Brain Sci Unit, Cambridge CB2 7EF, England.
    Cognitive bias modification to prevent depression (COPE): study protocol for a randomised controlled trial2014In: Trials, E-ISSN 1745-6215, Vol. 15, article id 282Article in journal (Refereed)
    Abstract [en]

    Background: Depression is a leading cause of disability worldwide and, although efficacious treatments are available, their efficacy is suboptimal and recurrence of symptoms is common. Effective preventive strategies could reduce disability and the long term social and health complications associated with the disorder, but current options are limited. Cognitive bias modification (CBM) is a novel, simple, and safe intervention that addresses attentional and interpretive biases associated with anxiety, dysphoria, and depression. The primary aim of this trial is to determine if CBM decreases the one-year onset of a major depressive episode among adults with subsyndromal depression. Design and methods: This randomised controlled trial will recruit 532 adults with subsyndromal symptoms of depression living in the Australian community (parallel design, 1:1 allocation ratio). Participants will be free of clinically significant symptoms of depression and of psychotic disorders, sensory and cognitive impairment, and risky alcohol use. The CBM intervention will target attentional and interpretive biases associated with depressive symptoms. The sessions will be delivered via the internet over a period of 52 weeks. The primary outcome of interest is the onset of a major depressive episode according the DSM-IV-TR criteria over a 12-month period. Secondary outcomes of interest include change in the severity of depressive symptoms as measured by the Patient Health Questionnaire (PHQ-9), use of antidepressants or benzodiazepines, and changes in attention and interpretive biases. The assessment of outcomes will take place 3, 6, 9, and 12 months after randomisation and will occur via the internet. Discussion: We propose to test the efficacy of an innovative intervention that is well grounded in theory and for which increasing empirical evidence for an effect on mood is available. The intervention is simple, inexpensive, easy to access, and could be easily rolled out into practice if our findings confirm a role for CBM in the prevention of depression.

  • 118.
    Almqvist, Daniel
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Psychiatry.
    Symptoms of Anti-NMDA receptor encephalitis - A pooled analysis of cases presenting with psychiatric symptoms2020Independent thesis Basic level (professional degree), 20 credits / 30 HE creditsStudent thesis
  • 119.
    Alnaes, Dag
    et al.
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res, KG Jebsen Ctr Psychosis Res, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Inst Clin Med, POB 4956 Nydalen, N-0424 Oslo, Norway..
    Kaufmann, Tobias
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res, KG Jebsen Ctr Psychosis Res, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Inst Clin Med, POB 4956 Nydalen, N-0424 Oslo, Norway..
    van der Meer, Dennis
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res, KG Jebsen Ctr Psychosis Res, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Inst Clin Med, POB 4956 Nydalen, N-0424 Oslo, Norway..
    Cordova-Palomera, Aldo
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res, KG Jebsen Ctr Psychosis Res, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Inst Clin Med, POB 4956 Nydalen, N-0424 Oslo, Norway..
    Rokicki, Jaroslav
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res, KG Jebsen Ctr Psychosis Res, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Inst Clin Med, POB 4956 Nydalen, N-0424 Oslo, Norway..
    Moberget, Torgeir
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res, KG Jebsen Ctr Psychosis Res, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Inst Clin Med, POB 4956 Nydalen, N-0424 Oslo, Norway..
    Bettella, Francesco
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res, KG Jebsen Ctr Psychosis Res, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Inst Clin Med, POB 4956 Nydalen, N-0424 Oslo, Norway..
    Agartz, Ingrid
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res, KG Jebsen Ctr Psychosis Res, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Inst Clin Med, POB 4956 Nydalen, N-0424 Oslo, Norway.;Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm, Sweden..
    Barch, Deanna M.
    Washington Univ, Dept Psychol & Brain Sci, St Louis, MO 63110 USA..
    Bertolino, Alessandro
    Univ Bari Aldo Moro, Dept Basic Med Sci Neurosci & Sense Organs, Psychiat Neurosci Grp, Bari, Italy..
    Brandt, Christine L.
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res, KG Jebsen Ctr Psychosis Res, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Inst Clin Med, POB 4956 Nydalen, N-0424 Oslo, Norway..
    Cervenka, Simon
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm, Sweden..
    Djurovic, Srdjan
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res, KG Jebsen Ctr Psychosis Res, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Inst Clin Med, POB 4956 Nydalen, N-0424 Oslo, Norway.;Oslo Univ Hosp, Dept Med Genet, Oslo, Norway..
    Doan, Nhat Trung
    Eisenacher, Sarah
    Heidelberg Univ, Cent Inst Mental Hlth, Mannheim, Germany..
    Fatouros-Bergman, Helena
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm, Sweden..
    Flyckt, Lena
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm, Sweden..
    Di Giorgio, Annabella
    Univ Bari Aldo Moro, Dept Basic Med Sci Neurosci & Sense Organs, Psychiat Neurosci Grp, Bari, Italy.;Fdn Ist Ricovero & Cura Carattere Sci Casa Sollie, San Giovanni Rotondo, Italy..
    Haatveit, Beathe
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res, KG Jebsen Ctr Psychosis Res, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Inst Clin Med, POB 4956 Nydalen, N-0424 Oslo, Norway..
    Jonsson, Erik G.
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res, KG Jebsen Ctr Psychosis Res, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Inst Clin Med, POB 4956 Nydalen, N-0424 Oslo, Norway.;Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden..
    Kirsch, Peter
    Heidelberg Univ, Cent Inst Mental Hlth, Mannheim, Germany.;Heidelberg Univ, Med Fac Mannheim, Mannheim, Germany..
    Lund, Martina J.
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res, KG Jebsen Ctr Psychosis Res, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Inst Clin Med, POB 4956 Nydalen, N-0424 Oslo, Norway..
    Meyer-Lindenberg, Andreas
    Heidelberg Univ, Cent Inst Mental Hlth, Mannheim, Germany.;Heidelberg Univ, Med Fac Mannheim, Mannheim, Germany..
    Pergola, Giulio
    Univ Bari Aldo Moro, Dept Basic Med Sci Neurosci & Sense Organs, Psychiat Neurosci Grp, Bari, Italy..
    Schwarz, Emanuel
    Heidelberg Univ, Cent Inst Mental Hlth, Mannheim, Germany..
    Smeland, Olav B.
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res, KG Jebsen Ctr Psychosis Res, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Inst Clin Med, POB 4956 Nydalen, N-0424 Oslo, Norway..
    Quarto, Tiziana
    Univ Bari Aldo Moro, Dept Basic Med Sci Neurosci & Sense Organs, Psychiat Neurosci Grp, Bari, Italy..
    Zink, Mathias
    Heidelberg Univ, Cent Inst Mental Hlth, Mannheim, Germany..
    Andreassen, Ole A.
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res, KG Jebsen Ctr Psychosis Res, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Inst Clin Med, POB 4956 Nydalen, N-0424 Oslo, Norway..
    Westlye, Lars T.
    Oslo Univ Hosp, Div Mental Hlth & Addict, Norwegian Ctr Mental Disorders Res, KG Jebsen Ctr Psychosis Res, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Inst Clin Med, POB 4956 Nydalen, N-0424 Oslo, Norway.;Univ Oslo, Dept Psychol, Oslo, Norway..
    Farde, Lars
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm, Sweden..
    Collste, Karin
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm, Sweden..
    Victorsson, Pauliina
    Karolinska Inst, Dept Clin Neurosci, Ctr Psychiat Res, Stockholm, Sweden.;Stockholm Cty Council, Stockholm, Sweden..
    Engberg, Goran
    Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden..
    Erhardt, Sophie
    Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden..
    Malmqvist, Anna
    Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden..
    Hedberg, Mikael
    Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden..
    Orhan, Funda
    Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden..
    Sellgren, Carl M.
    Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden..
    Schwieler, Lilly
    Karolinska Inst, Dept Physiol & Pharmacol, Stockholm, Sweden..
    Piehl, Fredrik
    Karolinska Inst, Dept Clin Neurosci, Neuroimmunol Unit, Stockholm, Sweden..
    Brain Heterogeneity in Schizophrenia and Its Association With Polygenic Risk2019In: JAMA psychiatry, ISSN 2168-6238, E-ISSN 2168-622X, Vol. 76, no 7, p. 739-748Article in journal (Refereed)
    Abstract [en]

    ImportanceBetween-individual variability in brain structure is determined by gene-environment interactions, possibly reflecting differential sensitivity to environmental and genetic perturbations. Magnetic resonance imaging (MRI) studies have revealed thinner cortices and smaller subcortical volumes in patients with schizophrenia. However, group-level comparisons may mask considerable within-group heterogeneity, which has largely remained unnoticed in the literature. ObjectivesTo compare brain structural variability between individuals with schizophrenia and healthy controls and to test whether respective variability reflects the polygenic risk score (PRS) for schizophrenia in an independent sample of healthy controls. Design, Setting, and ParticipantsThis case-control and polygenic risk analysis compared MRI-derived cortical thickness and subcortical volumes between healthy controls and patients with schizophrenia across 16 cohorts and tested for associations between PRS and MRI features in a control cohort from the UK Biobank. Data were collected from October 27, 2004, through April 12, 2018, and analyzed from December 3, 2017, through August 1, 2018. Main Outcomes and MeasuresMean and dispersion parameters were estimated using double generalized linear models. Vertex-wise analysis was used to assess cortical thickness, and regions-of-interest analyses were used to assess total cortical volume, total surface area, and white matter, subcortical, and hippocampal subfield volumes. Follow-up analyses included within-sample analysis, test of robustness of the PRS threshold, population covariates, outlier removal, and control for image quality. ResultsA comparison of 1151 patients with schizophrenia (mean [SD] age,33.8[10.6] years; 68.6% male [n=790] and 31.4% female [n=361]) with 2010 healthy controls (mean [SD] age,32.6[10.4] years; 56.0% male [n=1126] and 44.0% female [n=884]) revealed higher heterogeneity in schizophrenia for cortical thickness and area (t = 3.34), cortical (t=3.24) and ventricle (t range, 3.15-5.78) volumes, and hippocampal subfields (t range, 2.32-3.55). In the UK Biobank sample of 12 490 participants (mean [SD] age,55.9 [7.5] years; 48.2% male [n=6025] and 51.8% female [n=6465]), higher PRS was associated with thinner frontal and temporal cortices and smaller left CA2/3 (t=-3.00) but was not significantly associated with dispersion. Conclusions and RelevanceThis study suggests that schizophrenia is associated with substantial brain structural heterogeneity beyond the mean differences. These findings may reflect higher sensitivity to environmental and genetic perturbations in patients, supporting the heterogeneous nature of schizophrenia. A higher PRS was associated with thinner frontotemporal cortices and smaller hippocampal subfield volume, but not heterogeneity. This finding suggests that brain variability in schizophrenia results from interactions between environmental and genetic factors that are not captured by the PRS. Factors contributing to heterogeneity in frontotemporal cortices and hippocampus are key to furthering our understanding of how genetic and environmental factors shape brain biology in schizophrenia.

  • 120.
    Alozkan Sever, Cansu
    et al.
    Vrije Univ Amsterdam, Dept Clin Neuro & Dev Psychol, Amsterdam, Netherlands.;Vrije Univ Amsterdam, WHO Collaborating Ctr Res & Disseminat Psychol In, Amsterdam, Netherlands.;Amsterdam Publ Hlth Res Inst, Amsterdam, Netherlands..
    Cuijpers, Pim
    Vrije Univ Amsterdam, Dept Clin Neuro & Dev Psychol, Amsterdam, Netherlands.;Vrije Univ Amsterdam, WHO Collaborating Ctr Res & Disseminat Psychol In, Amsterdam, Netherlands.;Amsterdam Publ Hlth Res Inst, Amsterdam, Netherlands..
    Mittendorfer-Rutz, Ellenor
    Karolinska Inst, Dept Clin Neurosci, Div Insurance Med, Stockholm, Sweden..
    Bryant, Richard A.
    Univ New South Wales, Sch Psychol, Sydney, NSW, Australia..
    Dawson, Katie S.
    Univ New South Wales, Sch Psychol, Sydney, NSW, Australia..
    Holmes, Emily A.
    Uppsala University, Disciplinary Domain of Humanities and Social Sciences, Faculty of Social Sciences, Department of Psychology.
    Mooren, Trudy
    Univ Utrecht, Dept Clin Psychol, Utrecht, Netherlands..
    Norredam, Marie Louise
    Univ Copenhagen, Sect Hlth Serv Res, Dept Publ Hlth, Danish Res Ctr Migrat Ethn & Hlth, Copenhagen, Denmark..
    Sijbrandij, Marit
    Vrije Univ Amsterdam, Dept Clin Neuro & Dev Psychol, Amsterdam, Netherlands.;Vrije Univ Amsterdam, WHO Collaborating Ctr Res & Disseminat Psychol In, Amsterdam, Netherlands.;Amsterdam Publ Hlth Res Inst, Amsterdam, Netherlands..
    Feasibility and acceptability of Problem Management Plus with Emotional Processing (PM plus EP) for refugee youth living in the Netherlands: study protocol2021In: European Journal of Psychotraumatology, ISSN 2000-8198, E-ISSN 2000-8066, Vol. 12, no 1, article id 1947003Article in journal (Refereed)
    Abstract [en]

    Background Refugee youth experience hardships associated with exposure to trauma in their homelands and during and after displacement, which results in higher rates of common mental disorders. The World Health Organization (WHO) developed Problem Management Plus (PM+), a non-specialist-delivered brief psychological intervention, for individuals who have faced adversity. PM+ comprises problem-solving, stress management, behavioural activation and strengthening social support. However, it does not include an emotional processing component, which is indicated in trauma-exposed populations. Objective This pilot randomized controlled trial (RCT) aims to evaluate the feasibility and acceptability of PM+, adapted to Syrian, Eritrean and Iraqi refugee youth residing in the Netherlands, with and without a newly developed Emotional Processing (EP) Module. Methods Refugee youth (N = 90) between 16 and 25 years of age will be randomized into PM+ with care-as-usual (CAU), (n = 30), PM+ with Emotional Processing (PM+EP) with CAU (n = 30) or CAU only (n = 30). Inclusion criteria are self-reported psychological distress (Kessler Psychological Distress Scale; K10 > 15) and impaired daily functioning (WHO Disability Assessment Schedule; WHODAS 2.0 > 16). Participants will be assessed at baseline, one-week post-intervention and three-month follow-up. The main outcome is the feasibility and acceptability of the adapted PM+ and PM+EP. The secondary outcomes are self-reported psychological distress, functional impairment, post-traumatic stress disorder (PTSD) symptom severity and diagnosis, social support, and self-identified problems. The pilot RCT will be succeeded by a process evaluation including trial participants, participants' significant others, helpers, and mental health professionals (n = 20) to evaluate their experiences with the PM+ and PM+EP programmes. Results and Conclusion This is the first study that evaluates the feasibility of PM+ for this age range with an emotional processing module integrated. The results may inform larger RCTs and implementation of PM+ interventions among refugee youth.

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  • 121. Alsterberg, Sara
    et al.
    Lövdahl, Elisabeth
    Malmö University, Faculty of Health and Society (HS).
    Stöd och bemötande under hepatit C-behandling vid en sprutbytesmottagning: En intervjustudie ur ett patientperspektiv2021Independent thesis Advanced level (degree of Master (One Year)), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Bakgrund: Personer som injicerar droger är en patiengrupp med somatisk och psykiatrisk samsjuklighet. På grund av stigma, personliga eller strukturella förutsättningar, undervker patientgruppen att söka vård. Det gör att internationells såväl som nationell forskning om patientgruppens omvårdnadsbehov är begränsad. Genom det av WHO uppsatta målet att globalt eliminera hepatit C till år 2030, startade ACTIONNE-studien år 2018. Med sprutbytesmottagningen i Malmö som plattform behandlades 50 personer som injicerar droger framgångsrikt för hepatit C. Genom ACTIONNE-studien gavs patienterns möjlighet att etablera en kontinuerlig kontakt med vården. Följsamheten var god vilket gör det betydelsefullt att beakta deras behov i sammanhanget, för att utifrån det skapa möjligheter att implementera en personcentrerad vård för gruppen. Syfte: Att utforska behovet av stöd och bemötande hos personer som genomgått hepatit C-behandling inom ACTIONNE-studien. Metod: Semistrukurerade intervjuer genomfördes med 17 personer som genongått hepatit C-behandling inom ACTIONNE-stiudien. Materialet anayserades med hjälp av kvalitativ innehållsanalys enligt Burnard (1991). Resultat: Analysen genererade två kategorier: Bekräftade min existens och Förmedlade gemenskap, med fem tillhörande rubriker. Alla kategorier uppstod mot tidigare erfarenheter av marginalisering, varför behovet att inte stigmatiseras framstod som det mest grundläggande. Slutsats: Informanterna i studien ville känna sig inkluderade och behövde känna tillit för att våga anförtro sig och be om hjälp. Tilliten byggde på validering, tillgänglighet och att få känna sig jämlik. Lyhördhet för gruppens förutsättningar och erfarenheter skapar grunden för alliansbyggande partnerskap, ur vilken framtida vård och behandling kan utvecklas. 

  • 122. Aluoja, Anu
    et al.
    Shlik, Jakov
    Vasar, Veiko
    Luuk, Kersti
    Leinsalu, Mall
    Development and psychometric properties of the Emotional State Questionnaire: a self-report questionnaire for depression and anxiety1999In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 53, no 6, p. 443-449Article in journal (Refereed)
    Abstract [en]

    Anxiety and depression are dimensions of emotional state that can be validly assessed with self-report measures. This article introduces a new self-report questionnaire for depression and anxiety (Emotional State Questionnaire (EST-Q)) and presents data on its reliability and validity. The items of the EST-Q were derived from diagnostic criteria of DSM-IV and ICD-10. Thirty-three items were rated on a five-point frequency scale. The questionnaire was administered to 194 inpatients with depressive and anxiety disorders and to a population sample of 479 subjects. According to the results of factor analysis, five subscales were formed: Depression, Anxiety, Agoraphobia-Panic, Fatigue, and Insomnia. EST-Q and subscales showed acceptable internal consistency (alpha = 0.69-0.88). Significant differences in subscales between patients and population and across diagnostic groups confirmed the discriminant validity of the instrument. Depression, Anxiety, and Agoraphobia-Panic subscales distinguished corresponding diagnostic groups. Fatigue and Insomnia appeared to assess nonspecific psychopathology dimensions characteristic of several psychiatric disorders.

  • 123.
    Alverbratt, Catrin
    et al.
    University West, Department of Health Sciences, Specialist Nursing programme. University West, Department of Health Sciences, Section for health promotion and care sciences.
    Berlin, Johan
    University West, Department of Social and Behavioural Studies, Division of Social Pedagogy and Sociology.
    Åström, Sture
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    Kauffeldt, Anders
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level. University West, Department of Health Sciences, Section for nursing - graduate level.
    Carlström, Eric
    University West, Department of Nursing, Health and Culture, Divison of Caring Sciences, postgraduate level.
    A New Working Method in Psychiatric Care: the impact of implementation2016In: International Journal of Public Administration, ISSN 0190-0692, E-ISSN 1532-4265, Vol. 40, no 3, p. 295-304Article in journal (Refereed)
    Abstract [en]

    An equal mix of organizational cultures is important for a successful implementation process. The aim of this study was to examine the implementation of a new working method in psychiatric hospital wards, representing different cultural characteristics. Descriptive quantitative data were collected at two hospitals (intervention and control). The results revealed one ward characterized by a mix of organizational cultures. This ward, compared with other intervention wards, showed the best results regarding patient assessed empowerment and participation. The result shows tentatively that organizational culture may have an impact on the implementation processes.

  • 124.
    Al-Wandi, Ahmed
    et al.
    Örebro University, School of Medical Sciences. University Health Care Research Centre.
    Holmberg, Christoffer
    School of Medical Sciences, Örebro University, Örebro, Sweden.
    Landén, Mikael
    Institute of Neuroscience and Physiology, the Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.
    Nordenskjöld, Axel
    Örebro University, School of Medical Sciences. University Health Care Research Centre.
    A systematic review and meta-analysis of maintenance treatment for psychotic depression2022In: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 76, no 6, p. 442-450Article, review/survey (Refereed)
    Abstract [en]

    PURPOSE: To perform a systematic review on the use of maintenance treatment to prevent relapse and recurrence in patients with psychotic unipolar or bipolar depression.

    METHODS: We conducted an electronic search in December 2019 (and an updated search in July 2021) of four databases (PubMed, Embase, PsycINFO, and Cochrane) to identify controlled studies comparing the relapse rates of patients receiving maintenance treatment for psychotic unipolar depression and psychotic bipolar depression. A meta-analysis was made that included three studies comparing antidepressant (AD) and antipsychotic (AP) combination therapy with AD monotherapy. We used the GRADE tool to assess the quality of evidence.

    RESULTS: We included five randomized controlled trials fulfilling the inclusion criteria, making three comparisons: (a) AD + AP versus AD monotherapy; (b) AD + AP versus AP monotherapy; (c) AD + electroconvulsive therapy versus AD monotherapy. The included studies only examined patients with psychotic unipolar depression. The largest included study reported a statistically significant advantage of AD + AP compared with AD monotherapy. We made a meta-analysis of the three studies comparing AD + AP combination therapy with AD monotherapy, which included 195 patients and 56 events. The meta-analysis did not show a statistically significant difference between these treatments.

    CONCLUSIONS: Contrary to the finding of the largest study, we did not find a statistically significant difference between AD + AP combination therapy and AD monotherapy in the meta-analysis. There is insufficient evidence to support the superiority of any treatment modality as maintenance treatment for psychotic depression. Further studies are required.

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    A systematic review and meta-analysis of maintenance treatment for psychotic depression
  • 125.
    Al-Wandi, Ahmed
    et al.
    Örebro University, School of Medical Sciences. University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Landén, Mikael
    Institute of Neuroscience and Physiology, the Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Nordenskjöld, Axel
    Örebro University, School of Medical Sciences. University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Antipsychotics in the maintenance phase for psychotic depression2024In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447, Vol. 149, no 1, p. 6-17Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This study aimed to associate antidepressants with versus without antipsychotics with readmission and suicide in patients with psychotic unipolar depression.

    METHODS: Swedish national registers were used to identify inpatients with psychotic unipolar depression, treated 2007-2016. The participants collected antidepressants with or without antipsychotics from a pharmacy within 14 days after discharge and were followed up for 2 years. The primary outcome was hospital readmission due to any psychiatric disorder, suicide attempt, or completed suicide. Cox regression was used to analyze the data, which were adjusted for sex, age, prior admissions, comorbidity, electroconvulsive therapy, and other pharmacological treatments.

    RESULTS: We identified 4391 patients, of which 2972 were in the antidepressant + antipsychotic combination therapy group, and 1419 were in the antidepressant monotherapy group. After 2 years, 42.3% and 36.6% of patients were readmitted or committed suicide in the combination therapy and monotherapy group, respectively. Monotherapy was significantly associated with a lower risk of reaching the outcome in the main analysis (hazard ratio = 0.86; 95% confidence interval: 0.77-0.95). The results went in the same direction in all sensitivity analyses.

    CONCLUSION: Our findings do not indicate any advantage of adding antipsychotics as adjunctive to antidepressants as maintenance treatment. Considering the wide use, known side effects, and the current lack of evidence supporting the benefit, further studies on the effect of antipsychotics in the maintenance phase of psychotic unipolar depression are urgently warranted.

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    Antipsychotics in the maintenance phase for psychotic depression
  • 126.
    Al-Wandi, Ahmed
    et al.
    Örebro University, School of Medical Sciences. University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Landén, Mikael
    Institute of Neuroscience and Physiology, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Nordenskjöld, Axel
    Örebro University, School of Medical Sciences. University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Electroconvulsive therapy in the maintenance phase of psychotic unipolar depression2024In: Acta Psychiatrica Scandinavica, ISSN 0001-690X, E-ISSN 1600-0447Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To determine whether the rates of readmissions and suicide vary in psychotic unipolar depression based on whether patients receive maintenance electroconvulsive therapy (M-ECT) following the initial series of ECT, and to examine if there is an age-dependent association.

    METHODS: We used Swedish national registries to identify hospitalized patients with psychotic unipolar depression, treated 2008-2019 who received ECT during their hospital stay. The patients who received subsequent M-ECT within 14 days after discharge were compared with those who did not. The primary composite outcome was time to readmission due to a psychiatric disorder, suicide attempt, or suicide within 2 years from discharge. Data were analyzed using Cox regression adjusted for previous psychiatric admissions, age, sex, comorbidity, and pharmacological treatment. We also conducted a within-individual analysis using the sign-test, with patients having ≥1 hospital episode followed by M-ECT and ≥1 hospital episode without M-ECT.

    RESULTS: A total of 1873 patients were included, of which 130 received M-ECT. There was no statistically significant group difference regarding the primary outcome in the whole sample. However, when stratified by age, there was a significant difference in favor of M-ECT for patients >65 years (adjusted hazard ratio 0.55, 95% confidence interval 0.35-0.87). The within-individual analysis, including 46 patients, significantly favored M-ECT.

    CONCLUSION: M-ECT was not associated with a differential risk of the composite of readmission and suicide in psychotic depression. Among patients >65 years, M-ECT was significantly associated with a decreased risk of the outcome. The possibility of residual confounding cannot be excluded.

  • 127.
    Ambrus, Livia
    et al.
    Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden, and.
    Sunnqvist, Charlotta
    Malmö University, Faculty of Health and Society (HS), Department of Care Science (VV).
    Asp, Marie
    Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden, and.
    Westling, Sofie
    Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden, and.
    Westrin, Åsa
    Department of Clinical Sciences, Section for Psychiatry, Lund University, Lund, Sweden, and.
    Coping and suicide risk in high risk psychiatric patients2020In: Journal of Mental Health, ISSN 0963-8237, E-ISSN 1360-0567, Vol. 29, no 1, p. 27-32Article in journal (Refereed)
    Abstract [en]

    Background: A dysfunctional use of coping strategies has repeatedly been linked to suicidal behaviour in non-psychiatric populations. However, data regarding association between coping strategies and suicidal behaviour in psychiatric populations are limited. Aims: The aim of the study was to investigate the possible relationship between self-reported suicide risk, suicidal ideation and coping strategies in three psychiatric cohorts. Method: Three cohorts of psychiatric patients were involved in the study; recent suicide attempters (n = 55), suicide attempters at follow-up 12 years after a suicide attempt (n = 38) and patients with ongoing depression without attempted suicide (n = 72). Patients filled in the self-rating version of The Suicide Assessment Scale (SUAS-S) from which items no. 17–20 addressing current suicidal ideation were extracted. To investigate coping strategies, the Coping Orientation of Problem Experience Inventory (COPE) was used. Results: In all cohorts, regression analyses showed that only avoidant coping was significantly correlated with the scores of SUAS-S adjusted for covariates. The items no. 17–20 correlated significantly to avoidant coping but not with other coping strategies in all cohorts. Conclusion: The results of this study indicate that among coping strategies only avoidant coping may be associated with suicide risk in psychiatric patients independently of history of attempted suicide.

  • 128. Aminoff, Sofie R
    et al.
    Jensen, Jimmy
    University of Oslo & Oslo University Hospital.
    Lagerberg, Trine V
    Andreassen, Ole A
    Melle, Ingrid
    Decreased self-reported arousal in schizophrenia during aversive picture viewing compared to bipolar disorder and healthy controls.2011In: Psychiatry Research, ISSN 0165-1781, E-ISSN 1872-7123, Vol. 185, no 3, p. 309-314Article in journal (Refereed)
    Abstract [en]

    Both schizophrenia (SCZ) and bipolar disorder (BD) are associated with disturbances in emotion processing. Previous studies suggest that patients with SCZ assess unpleasant pictures as less arousing than healthy controls (HC), while patients with BD assess neutral pictures as more arousing than HC. No previous studies have investigated whether there is a difference in emotional response across all three groups. Our aim was to explore whether there was a difference in the evaluation of valence and in arousal between SCZ, BD and HC for aversive and neutral pictures. We showed 72 pictures (neutral, non-socially aversive and socially aversive) from the International Affective Picture System (IAPS) to 347 subjects. There was a clear interaction effect between the diagnostic group and increasing picture aversiveness for both valence and arousal. There were no significant differences in valence ratings between the different groups or in arousal ratings on any type of stimuli between BD patients and HC. However, SCZ patients reported significantly lower arousal for aversive stimuli, particularly with a social content, when compared to BD patients and HC. This was more pronounced in females. The presence of lifetime psychotic symptoms did not influence emotional responses.

  • 129.
    Aminoff, Victoria
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Bobeck, Johan
    Linköping University, Department of Biomedical and Clinical Sciences, Division of Children's and Women's Health. Linköping University, Faculty of Medicine and Health Sciences.
    Hjort, Sofia
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Sorliden, Elise
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Ludvigsson, Mikael
    Linköping University, Department of Biomedical and Clinical Sciences, Center for Social and Affective Neuroscience. Linköping University, Department of Health, Medicine and Caring Sciences. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Psykiatricentrum, Psykiatriska kliniken i Linköping. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.
    Berg, Matilda
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences. Karolinska Inst, Sweden.
    Tailored internet-based psychological treatment for psychological problems during the COVID-19 pandemic: A randomized controlled trial2023In: Internet Interventions, ISSN 2214-7829, Vol. 34, article id 100662Article in journal (Refereed)
    Abstract [en]

    The COVID-19 pandemic influence mental health in both infected and non-infected populations. In this study we examined if individually tailored internet-based cognitive behavioral therapy (ICBT) could be an effective treatment for psychological symptoms related to the pandemic. Following recruitment we included 76 participants who were randomized to either a treatment group (n = 37) or a waitlist control group (n = 39). The treatment group received 8 modules (out of 16 possible) during 8 weeks with weekly therapist support. We collected data on symptoms of depression, experienced quality of life, anxiety, stress, anger, insomnia, PTSD, and alcohol use before, after the treatment and at one year follow-up. Using multiple regression analysis, group condition was found to be a statistically significant predictor for a decrease, favoring the treatment group, in symptoms of depression, insomnia, and anger with small to moderate effect sizes. The improvements remained at one year follow-up. Group condition did not significantly predict changing symptoms regarding experienced quality of life, anxiety, stress, PTSD and alcohol use. Findings indicate that ICBT is an effective intervention for some psychological symptoms associated with the COVID-19 pandemic. There is a need for further studies on mechanisms of change and on tailored ICBT for problems associated with crises like the pandemic.

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  • 130.
    Anbesse, Birke
    et al.
    St Paul's General Specialized Hospital, PO Box 31657, Addis Ababa, Ethiopia.
    Hanlon, Charlotte
    King's College London, Institute of Psychiatry, London, UK.
    Alem, Atalay
    Department of Psychiatry, Addis Ababa University, Addis Ababa, Ethiopia.
    Packer, Samuel
    University of Toronto, Centre for Addiction and Mental Health, Toronto, Canada.
    Whitley, Rob
    Department of Psychiatry, Dartmouth Medical School, New Hampshire-Dartmouth Psychiatric Research Centre, Lebanon, USA.
    Migration and mental health: a study of low-income Ethiopian women working in Middle Eastern countries.2009In: International Journal of Social Psychiatry, ISSN 0020-7640, E-ISSN 1741-2854, Vol. 55, no 6, p. 557-68Article in journal (Refereed)
    Abstract [en]

    Background: Few studies have explored influences on mental health of migrants moving between non-Western countries.

    Methods: Focus group discussions were used to explore the experiences of Ethiopian female domestic migrants to Middle Eastern countries, comparing those who developed severe mental illness with those remaining mentally well.

    Discussion: Prominent self-identified threats to mental health included exploitative treatment, enforced cultural isolation, undermining of cultural identity and disappointment in not achieving expectations. Participants countered these risks by affirming their cultural identity and establishing socio-cultural supports.

    Conclusions: Mental health of migrant domestic workers may be jeopardized by stressors, leading to experience of social defeat.

  • 131.
    Anbessie, Mohammed N.
    et al.
    Univ Calif San Francisco, Global Brain Hlth Inst, San Francisco, CA 94143 USA.;Amanuel Mental Specialized Hosp, Dept Psychiat, Res & Training Directorate, Addis Ababa, Ethiopia..
    Belete, Yonas L.
    Univ Calif San Francisco, Global Brain Hlth Inst, San Francisco, CA 94143 USA..
    Ayele, Biniyam A.
    Univ Calif San Francisco, Global Brain Hlth Inst, San Francisco, CA 94143 USA.;Addis Ababa Univ, Coll Hlth Sci, Dept Neurol, Addis Ababa, Ethiopia..
    Valcour, Victor
    Univ Calif San Francisco, Global Brain Hlth Inst, San Francisco, CA 94143 USA.;Univ Calif San Francisco, Memory & Aging Ctr, Med Ctr, San Francisco, CA 94143 USA..
    Kavanagh, Niall
    Univ Calif San Francisco, Global Brain Hlth Inst, San Francisco, CA 94143 USA..
    Prioleau, Caroline
    Univ Calif San Francisco, Global Brain Hlth Inst, San Francisco, CA 94143 USA..
    Yohannes, Kalkidan
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, SWEDESD - Sustainability Learning and Research Centre. Uppsala University, WoMHeR (Centre for Women’s Mental Health during the Reproductive Lifespan). Dilla Univ, Coll Hlth & Med Sci, Dept Psychiat, Dilla, Ethiopia..
    Media for advocacy of mental health in the Ethiopian context. Current practice, gaps, and future directions2023In: Frontiers in Psychiatry, E-ISSN 1664-0640, Vol. 14, article id 1248827Article in journal (Refereed)
    Abstract [en]

    Media plays a crucial role in reshaping societal attitudes and behaviors towards individuals with mental illness. It contributes to improved rights of people living with mental health conditions and access to care services. However, in Ethiopia, mental health advocacy faces obstacles such as deep-rooted misconceptions, fear, and discrimination about mental illness, as well limited engagement of stakeholders and language barriers. Both mainstream and social media play a large role in disseminating mental health topics in Ethiopia. However, they need organized initiatives and efforts in order to be successful in promoting mental health awareness to the public. Implementing a comprehensive strategy comprising public awareness campaigns, policy advocacy, community engagement, stakeholder collaboration, responsible reporting, and increased coverage of mental health topics is crucial. The World Health Organization also emphasizes the role of health ministries in supporting mental health advocacy efforts. By promoting education, challenging stigmas, and improving access to mental health services, media advocacy can contribute to creating a more informed and supportive society for individuals with mental illness in Ethiopia.

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  • 132.
    Anders Eriksson, Mats
    et al.
    Karolinska Institute, Sweden; Karolinska University Hospital, Sweden; Gothenburg University, Sweden.
    Lieden, Agne
    Karolinska Institute, Sweden; Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Westerlund, Joakim
    Stockholm University, Sweden.
    Bremer, Anna
    Linköping University, Department of Clinical and Experimental Medicine, Division of Cell Biology. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Pathology and Clinical Genetics. Division of Clinical Genetics, University Hospital, Link.
    Wincent, Josephine
    Karolinska Institute, Sweden; Karolinska Institute, Sweden.
    Sahlin, Ellika
    Karolinska Institute, Sweden; Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Gillberg, Christopher
    Gothenburg University, Sweden.
    Fernell, Elisabeth
    Gothenburg University, Sweden.
    Anderlid, Britt-Marie
    Karolinska Institute, Sweden; Karolinska Institute, Sweden; Karolinska University Hospital, Sweden.
    Rare copy number variants are common in young children with autism spectrum disorder2015In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, no 6, p. 610-618Article in journal (Refereed)
    Abstract [en]

    AimSeveral studies have suggested that rare copy number variants (CNVs) are an important genetic contributor to autism spectrum disorders. The aims of the study were to use chromosomal microarray to investigate the presence of rare copy number variants in a population-based cohort of well-characterised young children with autism spectrum disorders and to relate the genetic results to neurodevelopmental profiles and medical conditions. MethodsWe performed chromosomal microarray on samples from 162 children who had been referred to the Stockholm Autism Centre for Young Children in Sweden after being diagnosed with autism spectrum disorder between 20 and 54months of age. ResultsPathogenic aberrations were detected in 8.6% of the children and variants of uncertain significance were present in another 8.6%. CNVs were more frequent in children with congenital malformations or dysmorphic features as well as in the subgroup with intellectual disability. ConclusionOur results support the use of chromosomal microarray methods for the first tier genetic analysis of autism spectrum disorder. However, it is likely in the near future that chromosomal microarray methods will probably be replaced by whole-exome and whole-genome sequencing technologies in clinical genetic testing.

  • 133.
    Andersen Helland, Wenche
    et al.
    Universitetet i Bergen, Norge.
    Biringer, Eva
    Helse Fonna HF, Norge.
    Helland, Turid
    Universitetet i Bergen, Norge.
    Heimann, Mikael
    Linköping University, Department of Behavioural Sciences and Learning, Developmental Psychology. Linköping University, Faculty of Arts and Sciences.
    Exploring language profiles for children with AD/HD and children with Asperger syndrome2012In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 16, no 1, p. 34-43Article in journal (Refereed)
    Abstract [en]

    Objective: The aims of the present study was to investigate communication impairments in a Norwegian sample of children with ADHD and children with Asperger syndrome (AS) and to explore whether children with ADHD can be differentiated from children with AS in terms of their language profiles on the Norwegian adaptation of the Children’s Communication Checklist Second Edition (CCC-2). Method: The CCC-2 was completed by the parents, and altogether, 77 children aged between 6 and 15 years participated in the study. Results: Communication impairments were as common in a group of children with ADHD as in a group of children with AS. Although a similar pattern appeared on most CCC-2 scales, children with ADHD and children with AS could be distinguished from each other in terms of their language profiles on the subscales assessing stereotyped language and nonverbal communication. Conclusion: Language abilities should be taken into account when standard assessments of ADHD and AS are performed and before therapies are initiated

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  • 134.
    Andersen Helland, Wenche
    et al.
    Universitetet i Bergen, Norge.
    Helland, Turid
    Universitetet i Bergen, Norge.
    Heimann, Mikael
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Language profiles and mental health problems in children with specific language imapirment and children with AD/HD2014In: Journal of Attention Disorders, ISSN 1087-0547, E-ISSN 1557-1246, Vol. 18, no 3, p. 226-235Article in journal (Refereed)
    Abstract [en]

    Objective: This study aimed to explore whether children with specific language impairment (SLI) and children with ADHDcan be differentiated from each other in terms of their language profiles, and also to investigate whether these two clinicalgroups differ regarding mental health problems. Method: A total of 59 children in the age range 6 to 12 years participatedin the study. The parents completed the Children’s Communication Checklist–Second Edition and the Strengths andDifficulties Questionnaire. Results: Communication impairments were as prominent in the ADHD group as in the SLIgroup; however, the groups were separable from each other in terms of their language profiles. Furthermore, the ADHDgroup experienced significantly more mental health problems compared with the SLI group. Conclusion: Language shouldbe assessed in children with ADHD and instruments sensitive to ADHD should be included when assessing children withSLI. Mental health should be an area of concern to be addressed in both groups. (J. of Att. Dis. 2012; XX(X) 1-XX)

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  • 135.
    Andersen, Lisa M. J.
    et al.
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Näswall, Katharina
    Department of Psychology, Stockholm University, Stockholm, Sweden; Department of Psychology, University of Canterbury, Christchurch, New Zealand.
    Manouilenko, Irina
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Nylander, Lena
    Department of Clinical Sciences, Psychiatry, Lund University, Lund, Sweden.
    Edgar, Johan
    Faculty of Health Sciences, Linköping University, Linköping, Sweden.
    Ritvo, Riva Ariella
    Yale Child Study Center, Yale University School of Medicine, New Haven, USA.
    Ritvo, Edward
    The Neuropsychiatric Institute, UCLA School of Medicine, Los Angeles, USA.
    Bejerot, Susanne
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    The Swedish version of the Ritvo autism and asperger diagnostic scale: revised (RAADS-R). A validation study of a rating scale for adults2011In: Journal of autism and developmental disorders, ISSN 0162-3257, E-ISSN 1573-3432, Vol. 41, no 12, p. 1635-1645Article in journal (Refereed)
    Abstract [en]

    There is a paucity of diagnostic instruments for adults with autism spectrum disorder (ASD). This study evaluates the psychometric properties of the Swedish version of the Ritvo Autism and Asperger Diagnostic Scale-Revised (RAADS-R), an 80-item self-rating scale designed to assist clinicians diagnosing ASD in adults. It was administered to 75 adults with ASD and 197 comparison cases. Also, a subset completed the Autism Spectrum Quotient (AQ). Three out of four subscales had high internal consistency. Sensitivity was 91% and specificity was 93%. The ASD subjects had significantly higher mean scores on all subscales. ASD females had higher scores than ASD males on the sensory motor subscale, a dimension not included in the AQ. RAADS-R showed promising test re-test reliability.

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    The Swedish Version of the Ritvo Autism and Asperger Diagnostic Scale: Revised (RAADS-R). A Validation Study of a Rating Scale for Adults
  • 136.
    Andersen, Peter Munch
    Umeå University, Faculty of Medicine, Department of Clinical Sciences, Neurosciences.
    Extensive heterogeneity in patients with ALS with mutations in SOD1 in France2021In: Journal of Neurology, Neurosurgery and Psychiatry, ISSN 0022-3050, E-ISSN 1468-330X, Vol. 92, no 9, p. 914-914Article in journal (Other academic)
  • 137.
    Andershed, Henrik
    et al.
    Örebro University, School of Law, Psychology and Social Work.
    Tuvblad, Catherine
    Utveckling av psykopati från barndom till vuxen ålder2016In: Psykopati / [ed] Mette K. F. Kreis, Helge Andreas Hoff, Henrik Belfrage & Stephen D. Hart, Lund: Studentlitteratur AB, 2016, p. 49-71Chapter in book (Other academic)
  • 138.
    Andersson, Anneli
    et al.
    Örebro University, School of Medical Sciences.
    Garcia-Argibay, Miguel
    Örebro University, School of Medical Sciences.
    Viktorin, Alexander
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
    Ghirardi, Laura
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
    Butwicka, Agnieszka
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden; Department of Child Psychiatry, Medical University of Warsaw, Warsaw, Poland; Child and Adolescent Psychiatry Stockholm, Stockholm Health Care Services, Region Stockholm, Sweden.
    Skoglund, Charlotte
    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of Neuroscience, Uppsala University, Uppsala, Sweden.
    Madsen, Kathrine Bang
    National Centre for Register-based Research, Business and Social Sciences, Aarhus University, Denmark; iPSYCH, the Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark.
    D'onofrio, Brian M.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden; The Department of Psychological and Brain Sciences at Indiana University, Bloomington, IN, United States.
    Lichtenstein, Paul
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden.
    Tuvblad, Catherine
    Örebro University, School of Law, Psychology and Social Work. Department of Psychology, University of Southern California, United States.
    Larsson, Henrik
    Örebro University, School of Medical Sciences. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden .
    Depression and anxiety disorders during the postpartum period in women diagnosed with attention deficit hyperactivity disorder2023In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 325, p. 817-823Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is associated with an increased risk of poor mental health. However, the understanding of ADHD-related burden and impairments in women during the postpartum period is limited. The aim with the present study was to examine the risk of depression and anxiety disorders during the postpartum period among women with and without an ADHD diagnosis.

    METHODS: We used register-based data to identify women who gave birth to their first and/or second child between 2005 and 2013 in Sweden (n = 773,047), of which 0.5 % (n = 3515) had a diagnosis of ADHD prior to pregnancy. Diagnoses of depression and anxiety disorders up to one year after delivery were collected from the national patient register.

    RESULTS: A total of 16.76 % of the women with an ADHD diagnosis were also diagnosed with depression disorders in the postpartum period, prevalence ratio (PR) 5.09 (95 % confidence interval (CI), 4.68-5.54). A total of 24.92 % of the women with an ADHD diagnosis were also diagnosed with anxiety disorders in the postpartum period, PR 5.41 (5.06-5.78). Stratified results revealed that having a diagnosis of ADHD increased the risk for both depression and anxiety disorders postpartum, beyond other well-known risk factors.

    LIMITATIONS: There is a potential risk of surveillance bias as women diagnosed with ADHD are more likely to have repeated visits to psychiatric care and might have an enhanced likelihood of also being diagnosed with depression and anxiety disorders postpartum, compared to women without ADHD.

    CONCLUSIONS: ADHD is an important risk factor for both depression and anxiety disorders postpartum. Therefore, ADHD needs to be considered in the maternal care, regardless of sociodemographic factors and the presence of other psychiatric disorders.

  • 139.
    Andersson, Anneli
    et al.
    Örebro Univ, Sch Behav Social & Legal Sci, Örebro, Sweden..
    Garcia-Argibay, Miguel
    Örebro Univ, Sch Med Sci, Örebro, Sweden..
    Viktorin, Alexander
    Karolinska Inst, Dept Med Epidemiol & Biostat, Solna, Sweden..
    Ghirardi, Laura
    Karolinska Inst, Dept Med Epidemiol & Biostat, Solna, Sweden..
    Butwicka, Agnieszka
    Karolinska Inst, Dept Med Epidemiol & Biostat, Solna, Sweden.;Stockholm Hlth Care Serv, Child & Adolescent Psychiat Stockholm, Stockholm, Region Stockhol, Sweden.;Med Univ Lodz, Dept Biostat & Translat Med, Lodz, Poland..
    Skoglund, Charlotte
    Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences.
    Madsen, Kathrine Bang
    Aarhus Univ, Natl Ctr Register based Res Business & Social Sci, Aarhus, Denmark..
    D'onofrio, Brian M.
    Karolinska Inst, Dept Med Epidemiol & Biostat, Solna, Sweden.;Indiana Univ, Dept Psychol & Brain Sci, Bloomington, IN USA.;Karolinska Inst, Dept Clin Neurosci, Stockholm, Sweden..
    Lichtenstein, Paul
    Karolinska Inst, Dept Med Epidemiol & Biostat, Solna, Sweden..
    Tuvblad, Catherine
    Örebro Univ, Sch Behav Social & Legal Sci, Örebro, Sweden.;Univ Southern Calif, Dept Psychol, Los Angeles, CA USA..
    Larsson, Henrik
    Örebro Univ, Sch Med Sci, Örebro, Sweden.;Karolinska Inst, Dept Med Epidemiol & Biostat, Solna, Sweden..
    Depression and anxiety disorders during the postpartum period in women diagnosed with attention deficit hyperactivity disorder2023In: Journal of Affective Disorders, ISSN 0165-0327, E-ISSN 1573-2517, Vol. 325, p. 817-823Article in journal (Refereed)
    Abstract [en]

    Background: Attention deficit hyperactivity disorder (ADHD) is associated with an increased risk of poor mental health. However, the understanding of ADHD-related burden and impairments in women during the postpartum period is limited. The aim with the present study was to examine the risk of depression and anxiety disorders during the postpartum period among women with and without an ADHD diagnosis.

    Methods: We used register-based data to identify women who gave birth to their first and/or second child between 2005 and 2013 in Sweden (n = 773,047), of which 0.5 % (n = 3515) had a diagnosis of ADHD prior to pregnancy. Diagnoses of depression and anxiety disorders up to one year after delivery were collected from the national patient register.

    Results: A total of 16.76 % of the women with an ADHD diagnosis were also diagnosed with depression disorders in the postpartum period, prevalence ratio (PR) 5.09 (95 % confidence interval (CI), 4.68-5.54). A total of 24.92 % of the women with an ADHD diagnosis were also diagnosed with anxiety disorders in the postpartum period, PR 5.41 (5.06-5.78). Stratified results revealed that having a diagnosis of ADHD increased the risk for both depression and anxiety disorders postpartum, beyond other well-known risk factors.Limitations: There is a potential risk of surveillance bias as women diagnosed with ADHD are more likely to have repeated visits to psychiatric care and might have an enhanced likelihood of also being diagnosed with depression and anxiety disorders postpartum, compared to women without ADHD.

    Conclusions: ADHD is an important risk factor for both depression and anxiety disorders postpartum. Therefore, ADHD needs to be considered in the maternal care, regardless of sociodemographic factors and the presence of other psychiatric disorders.

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  • 140.
    Andersson, Anneli
    et al.
    Örebro University, School of Medical Sciences.
    Hegvik, Tor-Arne
    Department of Biomedicine, University of Bergen, Bergen, Norway; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
    Chen, Qi
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
    Rosenqvist, Mina A.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
    Kvalvik, Liv Grimstvedt
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
    Almqvist, Catarina
    Karolinska Inst, Dept Med Epidemiol & Biostat, Solna, Sweden.;Karolinska Univ Hosp, Astrid Lindgren Childrens Hosp, Pediat Allergy & Pulmonol Unit, Solna, Sweden; Pediatric Allergy and Pulmonology Unitat Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Solna, Sweden.
    D'Onofrio, Brian M.
    Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden; The Department of Psychological and Brain Sciences at Indiana University, Bloomington Indiana, United States of America.
    Hartman, Catharina
    Department of Psychiatry,University of Groningen University Medical Center, Groningen, The Netherlands.
    Klungsøyr, Kari
    Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Division for Mental and PhysicalHealth, Norwegian Institute of Public Health, Bergen, Norway.
    Haavik, Jan
    Department of Biomedicine, University of Bergen, Bergen, Norway; Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.
    Tuvblad, Catherine
    Örebro University, School of Law, Psychology and Social Work. Department of Psychology, University of Southern California, Los Angeles California, United States of America.
    Larsson, Henrik
    Örebro University, School of Medical Sciences. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden.
    Attention-deficit/hyperactivity disorder and smoking habits in pregnant women2020In: PLOS ONE, E-ISSN 1932-6203, Vol. 15, no 6, article id e0234561Article in journal (Refereed)
    Abstract [en]

    Background: Attention-deficit/hyperactivity disorder (ADHD) has been associated with an increased risk of tobacco smoking, and more difficulties with smoking cessation compared to non-ADHD individuals. Women with ADHD may therefore show elevated rates of smoking during pregnancy.

    Aims: To examine the association between ADHD and smoking habits among pregnant women in Sweden and Norway.

    Methods: Women pregnant for the first time were identified in Sweden (n = 622,037), and Norway (n = 293,383), of which 1.2% (n = 7,444), and 1.7% (n = 4,951) were defined as having ADHD, respectively. Data on smoking habits were collected early and late in pregnancy.

    Results: In Sweden, ADHD was associated with an increased risk of smoking early in pregnancy, adjusted risk ratio (adjRR) 2.69 (95% confidence interval, 2.58-2.81), and late in pregnancy, adjRR 2.95 (2.80-3.10). Similar findings were observed in the Norwegian data, early in pregnancy, adjRR 2.31 (2.21-2.40), and late in pregnancy, adjRR 2.56 (2.42-2.70). Women with ADHD were more likely to continue smoking during pregnancy, compared to women without ADHD, both in Sweden adjRR 1.13 (1.10-1.17), and in Norway, adjRR 1.16 (1.12-1.20). Having a sibling diagnosed with ADHD was associated with an increased risk of smoking early and late in pregnancy, in both Sweden and Norway.

    Conclusions: Women with ADHD are considerably more likely to smoke early and late in (their first) pregnancy and are less likely to stop smoking between the two time points. Smoking, early and late in pregnancy, co-aggregates in families with ADHD. Smoking prevention and intervention programs should be targeted towards women with ADHD, specifically during their childbearing years, to ensure better mother and child outcomes.

  • 141.
    Andersson, Anneli
    et al.
    Örebro University, School of Medical Sciences.
    Tuvblad, Catherine
    Örebro University, School of Law, Psychology and Social Work. Department of Psychology, University of Southern California, Los Angeles, CA, USA.
    Chen, Qi
    Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden.
    Du Rietz, Ebba
    Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden.
    Cortese, Samuele
    Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life sciences & Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK; New York University Child Study Center, New York, NY, USA.
    Kuja-Halkola, Ralf
    Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden.
    Larsson, Henrik
    Örebro University, School of Medical Sciences. Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden.
    Research Review: The strength of the genetic overlap between ADHD and other psychiatric symptoms - a systematic review and meta-analysis2020In: Journal of Child Psychology and Psychiatry, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 61, no 11, p. 1173-1183Article, review/survey (Refereed)
    Abstract [en]

    Background: Attention-deficit/hyperactivity disorder (ADHD) frequently co-occurs with other psychiatric disorders. Twin studies have established that these co-occurrences are in part due to shared genetic risks. However, the strength of these genetic overlaps and the potential heterogeneity accounted for by type of psychiatric symptoms, age, and methods of assessment remain unclear. We conducted a systematic review to fill this gap.

    Methods: We searched PubMed, PsycINFO, Embase, and Web of Science until March 07, 2019. Genetic correlations (r(g)) were used as effect size measures.

    Results: A total of 31 independent studies fulfilled the inclusion criteria. The pooled estimates showed that the associations between ADHD and other psychiatric symptoms were partly explained by shared genetic factors, with a pooled genetic correlation of 0.50, 95% confidence interval: 0.46-0.60. The genetic correlations (r(g)) between ADHD and externalizing (r(g) = .49 [0.37-0.61]), internalizing (r(g) = .50 [0.39-0.69]), and neurodevelopmental (r(g) = .56 [0.47-0.66]) symptoms were similar in magnitude. The genetic correlations in childhood and adulthood werer(g) = .53 (0.43-0.63) andr(g) = .51 (0.44-0.56), respectively. For methods of assessment, the genetic correlations were also similar in strength, self-reportsr(g) = .52 (0.47-0.58), other informantsr(g) = .55 (0.41-0.69), and combined ratersr(g) = .50 (0.33-0.65).

    Conclusions: These findings indicate that the co-occurrence of externalizing, internalizing, and neurodevelopmental disorder symptoms in individuals with ADHD symptoms in part is due to a shared genetic risk.

  • 142.
    Andersson, Claes
    et al.
    Malmö University, Faculty of Health and Society (HS), Department of Criminology (KR).
    Vasiljevic, Zoran
    Malmö University, Faculty of Health and Society (HS), Department of Criminology (KR).
    Höglund, Peter
    Lund University, Sweden.
    Öjehagen, Agneta
    Lund University, Sweden.
    Berglund, Mats
    Lund University, Sweden.
    Daily Automated Telephone Assessment and Intervention Improved 1-Month Outcome in Paroled Offenders2020In: International journal of offender therapy and comparative criminology, ISSN 0306-624X, E-ISSN 1552-6933, Vol. 64, no 8, p. 735-752Article in journal (Refereed)
    Abstract [en]

    This randomized trial evaluates whether automated telephony could be used to perform daily assessments in paroled offenders (N = 108) during their first 30 days after leaving prison. All subjects were called daily and answered assessment questions. Based on the content of their daily assessments, subjects in the intervention group received immediate feedback and a recommendation by automated telephony, and their probation officers also received a daily report by email. The outcome variables were analyzed using linear mixed models. The intervention group showed greater improvement than the control group in the summary scores (M = 9.6, 95% confidence interval [CI] = [0.5, 18.7], p = .038), in mental symptoms (M = 4.6, CI = [0.2, 9.0], p = .042), in alcohol drinking (M = 0.8, CI = [0.1, 1.4], p = .031), in drug use (M = 1.0, CI = [0.5, 1.6], p = .000), and in most stressful daily event (M = 1.9, CI = [1.1, 2.7], p = .000). In conclusion, automated telephony may be used to follow up and to give interventions, resulting in reduced stress and drug use, in paroled offenders.

  • 143.
    Andersson, David
    et al.
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Magnusson, Henrik
    Linköping University, Department of Medical and Health Sciences, Physiotherapy. Linköping University, Faculty of Health Sciences.
    Carstensen, John
    Linköping University, Department of Medical and Health Sciences, Health and Society. Linköping University, Faculty of Arts and Sciences.
    Borgquist, Lars
    Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Co-morbidity and health care utilisation five years prior to diagnosis for depression: A register-based study in a Swedish population2011In: BMC Public Health, E-ISSN 1471-2458, Vol. 11, p. 552-Article in journal (Refereed)
    Abstract [en]

    Background

    Depressive disorders have been associated with a number of co-morbidities, and we   hypothesized that patients with a depression diagnosis would be heavy users of health   care services, not only when first evaluated for depression, but also for preceding   years. The aim of this study was to investigate whether increased health care utilisation   and co-morbidity could be seen during five years prior to an initial diagnosis of   depression.

    Methods

    We used a longitudinal register-based study design. The setting comprised the general   population in the county of Östergötland, south-east Sweden. All 2470 patients who   were 20 years or older in 2006 and who received a new diagnosis of depression (F32   according to ICD-10) in 2006, were selected and followed back to the year 2001, five   years before their depression diagnosis. A control group was randomly selected among   those who were aged 20 years or over in 2006 and who had received no depression diagnosis   during the period 2001-2006.

    Results

    Predictors of a depression diagnosis were a high number of physician visits, female   gender, age below 60, age above 80 and a low socioeconomic status.

    Patients who received a diagnosis of depression used twice the amount of health care   (e.g. physician visits and hospital days) during the five year period prior to diagnosis   compared to the control group. A particularly strong increase in health care utilisation   was seen the last year before diagnosis. These findings were supported with a high   level of co-morbidity as for example musculoskeletal disorders during the whole five-year   period for patients with a depression diagnosis.

    Conclusions

    Predictors of a depression diagnosis were a high number of physician visits, female   gender, age below 60, age above 80 and a low socioeconomic status. To find early signs   of depression in the clinical setting and to use a preventive strategy to handle these   patients is important.

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  • 144.
    Andersson, Erik
    et al.
    Karolinska Inst, Dept Clin Neurosci, Div Psychol, Stockholm, Sweden.;Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Hedman, Erik
    Karolinska Inst, Dept Clin Neurosci, Div Psychol, Stockholm, Sweden.;Karolinska Inst, Dept Clin Neurosci, Osher Ctr Integrat Med, Stockholm, Sweden..
    Enander, Jesper
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Djurfeldt, Diana Radu
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Ljotsson, Brjann
    Karolinska Inst, Dept Clin Neurosci, Div Psychol, Stockholm, Sweden..
    Cervenka, Simon
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Isung, Josef
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Svanborg, Cecilia
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Mataix-Cols, David
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Kaldo, Viktor
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Andersson, Gerhard
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden.;Linkoping Univ, Dept Behav Sci & Learning, Linkoping, Sweden..
    Lindefors, Nils
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    Ruck, Christian
    Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden..
    D-Cycloserine vs Placebo as Adjunct to Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder and Interaction With Antidepressants A Randomized Clinical Trial2015In: JAMA psychiatry, ISSN 2168-6238, E-ISSN 2168-622X, Vol. 72, no 7, p. 659-667Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE It is unclear whether D-cycloserine (DCS), a partial N-methyl-D-aspartate agonist that enhances fear extinction, can augment the effects of exposure-based cognitive behavioral therapy (CBT) for obsessive-compulsive disorder (OCD). OBJECTIVES To examine whether DCS augments the effects of CBT for OCD and to explore (post hoc) whether concomitant antidepressant medication moderates the effects of DCS. DESIGN, SETTING, AND PARTICIPANTS A 12-week, double-blind randomized clinical trial with 3-month follow-up conducted at an academic medical center between September 4, 2012, and September 26, 2013. Participants included 128 adult outpatients with a primary diagnosis of OCD and a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score of 16 or higher. Concurrent antidepressant medication was permitted if the dose had been stable for at least 2 months prior to enrollment and remained unchanged during the trial. The main analysis was by intention-to-treat population. INTERVENTIONS All participants received a previously validated Internet-based CBT protocol over 12 weeks and were randomized to receive either 50 mg of DCS or placebo, administered 1 hour before each of 5 exposure and response prevention tasks. MAIN OUTCOMES AND MEASURES Clinician-administered Y-BOCS score at week 12 and at 3-month follow-up. Remission was defined as a score of 12 or lower on the Y-BOCS. RESULTS In the primary intention-to-treat analyses, DCS did not augment the effects of CBT compared with placebo (mean [SD] clinician-rated Y-BOCS score, DCS: 13.86 [6.50] at week 12 and 12.35 [7.75] at 3-month follow-up; placebo: 11.77 [5.95] at week 12 and 12.37 [6.68] at 3-month follow-up) but showed a significant interaction with antidepressants (clinician-rated Y-BOCS, B = -1.08; Z = -2.79; P = .005). Post hoc analyses revealed that antidepressants significantly impaired treatment response in the DCS group but not the placebo group, at both posttreatment and follow-up (clinician-rated Y-BOCS: t(62) = -3.00; P = .004; and t(61) = -3.49; P < .001, respectively). In the DCS group, a significantly greater proportion of antidepressant-free patients achieved remission status at follow-up (60% [95% CI, 45%-74%]) than antidepressant-medicated patients (24% [95% CI, 9%-48%]) (P = .008). Antidepressants had no effect in the placebo group (50% [95% CI, 36%-64%] remission rate in both groups). CONCLUSIONS AND RELEVANCE The findings suggest that antidepressants may interact with DCS to block its facilitating effect on fear extinction. Use of DCS may be a promising CBT augmentation strategy but only in antidepressant-free patients with OCD.

  • 145.
    Andersson, Erik
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Hedman, Erik
    Karolinska Institutet, Stockholm, Sweden.
    Enander, Jesper
    Karolinska Institutet, Stockholm, Sweden.
    Radu Djurfeldt, Diana
    Karolinska Institutet, Stockholm, Sweden.
    Ljótsson, Brjánn
    Karolinska Institutet, Stockholm, Sweden.
    Cervenka, Simon
    Karolinska Institutet, Stockholm, Sweden.
    Isung, Josef
    Karolinska Institutet, Stockholm, Sweden.
    Svanborg, Cecilia
    Karolinska Institutet, Stockholm, Sweden.
    Mataix-Cols, David
    Karolinska Institutet, Stockholm, Sweden.
    Kaldo, Viktor
    Karolinska Institutet, Stockholm, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Inst, Div Psychiat, Dept Clin Neurosci, Stockholm, Sweden.
    Lindefors, Nils
    Karolinska Institutet, Stockholm, Sweden.
    Rück, Christian
    Karolinska Institutet, Stockholm, Sweden.
    D-Cycloserine vs Placebo as Adjunct to Cognitive Behavioral Therapy for Obsessive-Compulsive Disorder and Interaction With Antidepressants: A Randomized Clinical Trial.2015In: JAMA psychiatry, ISSN 2168-6238, E-ISSN 2168-622X, Vol. 72, no 7, p. 659-667Article in journal (Refereed)
    Abstract [en]

    IMPORTANCE: It is unclear whether d-cycloserine (DCS), a partial N-methyl-d-aspartate agonist that enhances fear extinction, can augment the effects of exposure-based cognitive behavioral therapy (CBT) for obsessive-compulsive disorder (OCD).

    OBJECTIVES: To examine whether DCS augments the effects of CBT for OCD and to explore (post hoc) whether concomitant antidepressant medication moderates the effects of DCS.

    DESIGN, SETTING, AND PARTICIPANTS: A 12-week, double-blind randomized clinical trial with 3-month follow-up conducted at an academic medical center between September 4, 2012, and September 26, 2013. Participants included 128 adult outpatients with a primary diagnosis of OCD and a Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score of 16 or higher. Concurrent antidepressant medication was permitted if the dose had been stable for at least 2 months prior to enrollment and remained unchanged during the trial. The main analysis was by intention-to-treat population.

    INTERVENTIONS: All participants received a previously validated Internet-based CBT protocol over 12 weeks and were randomized to receive either 50 mg of DCS or placebo, administered 1 hour before each of 5 exposure and response prevention tasks.

    MAIN OUTCOMES AND MEASURES: Clinician-administered Y-BOCS score at week 12 and at 3-month follow-up. Remission was defined as a score of 12 or lower on the Y-BOCS.

    RESULTS: In the primary intention-to-treat analyses, DCS did not augment the effects of CBT compared with placebo (mean [SD] clinician-rated Y-BOCS score, DCS: 13.86 [6.50] at week 12 and 12.35 [7.75] at 3-month follow-up; placebo: 11.77 [5.95] at week 12 and 12.37 [6.68] at 3-month follow-up) but showed a significant interaction with antidepressants (clinician-rated Y-BOCS, B = -1.08; Z = -2.79; P = .005). Post hoc analyses revealed that antidepressants significantly impaired treatment response in the DCS group but not the placebo group, at both posttreatment and follow-up (clinician-rated Y-BOCS: t62 = -3.00; P = .004; and t61 = -3.49; P < .001, respectively). In the DCS group, a significantly greater proportion of antidepressant-free patients achieved remission status at follow-up (60% [95% CI, 45%-74%]) than antidepressant-medicated patients (24% [95% CI, 9%-48%]) (P = .008). Antidepressants had no effect in the placebo group (50% [95% CI, 36%-64%] remission rate in both groups).

    CONCLUSIONS AND RELEVANCE: The findings suggest that antidepressants may interact with DCS to block its facilitating effect on fear extinction. Use of DCS may be a promising CBT augmentation strategy but only in antidepressant-free patients with OCD.

    TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01649895.

  • 146.
    Andersson, Eva
    et al.
    Swedish School of Sport and Health Sciences, GIH, Department of Sport and Health Sciences, Laboratory for Biomechanics and Motor Control.
    Hovland, Anders
    Kjellman, Bengt
    Taube, Jill
    Martinsen, Egil W.
    Fysisk aktivitet är lika bra som läkemedel eller samtalsterapi vid depression2016In: Idrottsmedicin, ISSN 2001-3302, Vol. 35, no 1, p. 4-7Article in journal (Other academic)
  • 147.
    Andersson, G.
    et al.
    Department of Behavioural Sciences and Learning, Linköping University, Sweden; Department of Clinical Neuroscience, Division of Psychiatry, Karolinska Institutet, Stockholm, Sweden .
    Bergman Nordgren, Lise
    Department of Behavioural Sciences and Learning, Linköping University, Sweden.
    Buhrman, M.
    Department of Psychology, Uppsala University, Uppsala, Sweden.
    Carlbring, P.
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Psychological treatments for depression delivered via the internet and supported by a clinician: An pdate: [Tratamientos psicológicos para la depresión aplicados a través de Internet y con el apoyo de un clínico: Una actualización]2014In: Revista de Psicopatologia y Psicologia Clinica, ISSN 1136-5420, Vol. 19, no 3, p. 217-225Article, review/survey (Refereed)
    Abstract [en]

    Guided internet-delivered cognitive behaviour therapy (ICBT) has been tested in many trials since the early studies dating back to the late 1990s. The aim of this review was to investigate the most recent literature on guided ICBT for depression. We identified 11 controlled studies published between January 2013 and September 2014. Overall, large treatment effects were observed with a few exceptions. A majority (7 studies) provided some information regarding unwanted effects such as deterioration. Three studies directly compared guided ICBT against face-to-face CBT. We added an earlier study and calculated meta-analytic summary statistics for the four studies involving a total of 336 participants. The average effect size difference was Hedges g = 0.12 (95% CI: -0.08∼0.32) in the direction of favouring guided ICBT, but with no practical importance. We conclude that guided ICBT is a promising treatment for depression and mood disorders and that the research is rapidly expanding.

  • 148.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Otorhinolaryngology. Linköping University, Department of Biomedical and Clinical Sciences. Linköping University, Faculty of Medicine and Health Sciences.
    Forskningsmetoder och consilience2021In: Psykisk ohälsa: ett biopsykosocialt perspektiv / [ed] Ali Sarkohi, Gerhard Andersson, Lund: Studentlitteratur AB, 2021, Vol. Sidorna 23-50, p. 23-50Chapter in book (Other academic)
    Abstract [sv]

    I denna bok omnämns flera olika psykiska ohälsotillstånd och mekanismerna bakom dem. I detta kapitel vill jag ge en översikt med några exempel på metoder för de olika nivåerna i den biopsykosociala modellen. Begreppet consilience, myntat av Edward O. Wilson, introducerades som ett ramverk för hur olika vetenskapstraditioner kan samverka och berika varandra. Jag går igenom olika metoder inom olika forskningstraditioner och avslutar med en diskussion om utmaningar med att förena olika angreppssätt i förståelsen av psykisk sjukdom.

  • 149.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Psykoterapi och psykologisk behandling2016In: Psykiatri / [ed] Jörgen Herlofson, Lund: Studentlitteratur, 2016, 2, p. 669-681Chapter in book (Other academic)
    Abstract [en]

    I den här delen av kapitlet går vi igenom psykoterapi och psykologisk behandling. Avsnittet belyser olika terapiformer och format, och en slutsats är att psykologisk behandling fungerar, samt att kombinerad behandling med samtidig läkemedelsbehandling kan vara mer effektiv än att endast erbjuda läkemedel eller psykologisk behandling. Olika psykoterapier har effekt men det finns än så länge mest stöd för kognitiv beteendeterapi.

  • 150. Andersson, Gerhard
    et al.
    Bergström, Jan
    Buhrman, Monica
    Carlbring, Per
    Holländare, Fredrik
    Örebro University, School of Health and Medical Sciences.
    Kaldo, Viktor
    Nilsson-Ihrfelt, Elisabeth
    Paxling, Björn
    Ström, Lars
    Waara, Johan
    Development of a new approach to guided self-help via the Internet: The Swedish experience2008In: Journal of technology in human services, ISSN 1522-8835, E-ISSN 1522-8991, Vol. 26, no 2-4, p. 161-181Article in journal (Refereed)
    Abstract [en]

    This article describes the development and empirical status of guided Internet-delivered self-help. The treatment approach combines the benefits of bibliotherapy with book-length text materials and the support given online via web pages and e-mail. Interactive features such as online registrations, tests, and online discussion forums are also included. Cognitive behavior therapy (CBT) guided the research and clinical implementations of this approach, as it lends itself more easily to the self-help format compared with other presently available psychotherapy approaches. We include an overview of the research, current issues and research in service delivery, lessons learned through a program of research, and directions for future investigations

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